Thirty-day perioperative safety following surgical intervention for unilateral and bilateral vocal fold paralysis: a multicenter ACS-NSQIP analysis

Surgical intervention for unilateral and bilateral vocal fold paralysis (UVFP and BVFP, respectively) aims to restore voice and airway patency, yet large-scale safety data remain sparse. This study evaluates 30-day perioperative safety outcomes across a multi-institutional cohort. The ACS-NSQIP database (2008–2023) was queried for patients undergoing laryngeal intervention for UVFP or BVFP. Preoperative characteristics, 30-day complications, and reoperation rates were analyzed. Of 931 patients, 857 (92%) had UVFP and 74 (8.0%) had BVFP. The overall complication rate was 3.3% ( n = 31), with a reoperation rate of 0.97% ( n = 9). No patient with BVFP and only one patient with UVFP required prolonged postoperative ventilation beyond 48 h. No significant differences were found between groups for major surgical or medical complications ( p > 0.05). Surgical intervention for UVFP and BVFP is a safe intervention with low morbidity. These findings provide a valuable benchmark for preoperative counseling and risk stratification. Future prospective studies are warranted to confirm our findings.